Helping a Loved One Who Self-injures

Reviewed Jul 8, 2017

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Summary

  • Determine whether the injuries require medical care.
  • Read about self-injury.
  • Encourage your loved one to seek care and support.

You might know someone who meets the description of the typical person Andrew Levander treats: A girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her arms, legs, or stomach. Unfortunately, the number of people who self-injure seems to be growing, says Levander, clinical director of a pioneering treatment program in Los Angeles. If you suspect a loved one is injuring herself, ignoring the problem won’t make it go away. Though it might seem scary or uncomfortable, you can help.

Why do people hurt themselves?

Teenage girls aren’t the only people who self-injure. The problem also affects adults and males, although in fewer numbers, experts believe.

“Why?” may be the hardest question for anyone who self-injures to answer. Some people attempt to control difficult emotions with alcohol, drugs, binge-eating, or purging. Other people may find relief in cutting themselves with razor blades or knives, explains Karen Contrario and Wendy Lader, PhD, authors of Bodily Harm: The Breakthrough Healing Program for Self-injurers. Other people who self-injure may hit themselves, pull out their hair, burn themselves, or scratch themselves.

“What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain,” says Levander. “It’s easier to understand pain they create, rather than pain inflicted on them.”

Self-inury may become a way to feel mastery of the helplessness and anger often resulting from abuse, neglect or invalidation. The behavior can be a tension release. “That’s one of the reasons why it becomes such a difficult behavior to end,” agrees Gabrielle Carlson, MD, Director of the Division of Child and Adolescent Psychiatry at Stony Brook University Hospital. “It’s such a relief to feel better.”

How you can help

Understanding why someone hurts herself and can’t just stop doing it may be difficult for you, too. Be prepared to deal with feelings of disgust and fear. I is important for you to comment on the behavior and convey concern, without criticizing. “(Healthy) relationships are the antidote,” Levander says. “Self-injury happens in the absence of relationships.”

People can’t be coerced into stopping the behavior. They have to be willing to try to change their behavior. Here is how you can help:

  • Determine whether the injuries require medical care. Always take care of a medical emergency first.
  • Read about self-injury. It is important to not try to be a mental health professional. It will likely overwhelm you and might harm the individual.
  • Make it clear that your loved one can talk to you about the behavior, and that you aren’t repulsed. It is alright to say that you are overwhelmed by the injuries and the pain they must be causing.
  • Encourage your loved one to seek care and support. Work with a health care professional to help the person. “There are better ways of dealing with tension than what they’re doing,” Carlson emphasizes.
  • Help your loved one get help to explore the reasons behind her behavior. 
  • Place the responsibility for the behavior on your loved one. If she tells you about an episode of self-injury, ask, “How would you like me to respond to that?”
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Set reasonable limits to help keep the relationship intact. You might say, “I can’t talk to you while you’re actually cutting yourself because it hurts too much to watch.”
  • Provide distractions if necessary.
  • Be patient. It can take a long time for a person to give up self-injury.

What not to do

People who self-injure may expect to receive angry, rejecting responses. Break that pattern.

  • Don’t give ultimatums. They won’t work.
  • Don’t expect the person to be able to “snap out of it.” Saying, “There, now it’s over,” is not helpful. Instead, say, “Let me help make it better.”
  • Don’t ask, “Is there anything I can do?” Find ways you can help and ask, “Can I?”
  • Don’t give pat responses. The emotions surrounding the problem are complicated. For example, if your loved one tells you she feels repulsive, don’t simply say, “You’re not repulsive.” Ask why, and explore those factors.
  • Set limits for yourself. The person’s needs may overwhelm you. Refer him to professional care, when appropriate.

You also have to care for yourself. You may feel frustrated and stressed. Make sure you set limits—as much as you care for your loved one, you might have to take a break. Seek out support for yourself.

Resources

The Healing House
www.healing-house.org
 
Helping Teens Who Cut: Understanding and Ending Self-Injury by Michael Hollander. The Guilford Press, 2008.

Stopping the Pain: A Workbook for Teens Who Cut and Self-Injure by Lawrence Shapiro. Instant Help, 2008.

By Kristen Knight
Source: Gabrielle Carlson, MD; Andrew Levander, MA, MAC; American Self-Harm Information Clearinghouse; BBC News; CNN.com; Discovery Health Channel; Focus Adolescent Services GuardianUnlimited; The Healing House; Vista Del Mar Child and Family Services; A Bright Red Scream: Self-mutilation and the Language of Pain by Marilee Strong; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian.

Summary

  • Determine whether the injuries require medical care.
  • Read about self-injury.
  • Encourage your loved one to seek care and support.

You might know someone who meets the description of the typical person Andrew Levander treats: A girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her arms, legs, or stomach. Unfortunately, the number of people who self-injure seems to be growing, says Levander, clinical director of a pioneering treatment program in Los Angeles. If you suspect a loved one is injuring herself, ignoring the problem won’t make it go away. Though it might seem scary or uncomfortable, you can help.

Why do people hurt themselves?

Teenage girls aren’t the only people who self-injure. The problem also affects adults and males, although in fewer numbers, experts believe.

“Why?” may be the hardest question for anyone who self-injures to answer. Some people attempt to control difficult emotions with alcohol, drugs, binge-eating, or purging. Other people may find relief in cutting themselves with razor blades or knives, explains Karen Contrario and Wendy Lader, PhD, authors of Bodily Harm: The Breakthrough Healing Program for Self-injurers. Other people who self-injure may hit themselves, pull out their hair, burn themselves, or scratch themselves.

“What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain,” says Levander. “It’s easier to understand pain they create, rather than pain inflicted on them.”

Self-inury may become a way to feel mastery of the helplessness and anger often resulting from abuse, neglect or invalidation. The behavior can be a tension release. “That’s one of the reasons why it becomes such a difficult behavior to end,” agrees Gabrielle Carlson, MD, Director of the Division of Child and Adolescent Psychiatry at Stony Brook University Hospital. “It’s such a relief to feel better.”

How you can help

Understanding why someone hurts herself and can’t just stop doing it may be difficult for you, too. Be prepared to deal with feelings of disgust and fear. I is important for you to comment on the behavior and convey concern, without criticizing. “(Healthy) relationships are the antidote,” Levander says. “Self-injury happens in the absence of relationships.”

People can’t be coerced into stopping the behavior. They have to be willing to try to change their behavior. Here is how you can help:

  • Determine whether the injuries require medical care. Always take care of a medical emergency first.
  • Read about self-injury. It is important to not try to be a mental health professional. It will likely overwhelm you and might harm the individual.
  • Make it clear that your loved one can talk to you about the behavior, and that you aren’t repulsed. It is alright to say that you are overwhelmed by the injuries and the pain they must be causing.
  • Encourage your loved one to seek care and support. Work with a health care professional to help the person. “There are better ways of dealing with tension than what they’re doing,” Carlson emphasizes.
  • Help your loved one get help to explore the reasons behind her behavior. 
  • Place the responsibility for the behavior on your loved one. If she tells you about an episode of self-injury, ask, “How would you like me to respond to that?”
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Set reasonable limits to help keep the relationship intact. You might say, “I can’t talk to you while you’re actually cutting yourself because it hurts too much to watch.”
  • Provide distractions if necessary.
  • Be patient. It can take a long time for a person to give up self-injury.

What not to do

People who self-injure may expect to receive angry, rejecting responses. Break that pattern.

  • Don’t give ultimatums. They won’t work.
  • Don’t expect the person to be able to “snap out of it.” Saying, “There, now it’s over,” is not helpful. Instead, say, “Let me help make it better.”
  • Don’t ask, “Is there anything I can do?” Find ways you can help and ask, “Can I?”
  • Don’t give pat responses. The emotions surrounding the problem are complicated. For example, if your loved one tells you she feels repulsive, don’t simply say, “You’re not repulsive.” Ask why, and explore those factors.
  • Set limits for yourself. The person’s needs may overwhelm you. Refer him to professional care, when appropriate.

You also have to care for yourself. You may feel frustrated and stressed. Make sure you set limits—as much as you care for your loved one, you might have to take a break. Seek out support for yourself.

Resources

The Healing House
www.healing-house.org
 
Helping Teens Who Cut: Understanding and Ending Self-Injury by Michael Hollander. The Guilford Press, 2008.

Stopping the Pain: A Workbook for Teens Who Cut and Self-Injure by Lawrence Shapiro. Instant Help, 2008.

By Kristen Knight
Source: Gabrielle Carlson, MD; Andrew Levander, MA, MAC; American Self-Harm Information Clearinghouse; BBC News; CNN.com; Discovery Health Channel; Focus Adolescent Services GuardianUnlimited; The Healing House; Vista Del Mar Child and Family Services; A Bright Red Scream: Self-mutilation and the Language of Pain by Marilee Strong; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian.

Summary

  • Determine whether the injuries require medical care.
  • Read about self-injury.
  • Encourage your loved one to seek care and support.

You might know someone who meets the description of the typical person Andrew Levander treats: A girl between the ages of 14 and 17, possibly with major depression or bipolar disorder, who cuts herself with a razor blade or glass on her arms, legs, or stomach. Unfortunately, the number of people who self-injure seems to be growing, says Levander, clinical director of a pioneering treatment program in Los Angeles. If you suspect a loved one is injuring herself, ignoring the problem won’t make it go away. Though it might seem scary or uncomfortable, you can help.

Why do people hurt themselves?

Teenage girls aren’t the only people who self-injure. The problem also affects adults and males, although in fewer numbers, experts believe.

“Why?” may be the hardest question for anyone who self-injures to answer. Some people attempt to control difficult emotions with alcohol, drugs, binge-eating, or purging. Other people may find relief in cutting themselves with razor blades or knives, explains Karen Contrario and Wendy Lader, PhD, authors of Bodily Harm: The Breakthrough Healing Program for Self-injurers. Other people who self-injure may hit themselves, pull out their hair, burn themselves, or scratch themselves.

“What the behavior does commonly … is to put them in a position of control over their body, to put them in charge of their pain,” says Levander. “It’s easier to understand pain they create, rather than pain inflicted on them.”

Self-inury may become a way to feel mastery of the helplessness and anger often resulting from abuse, neglect or invalidation. The behavior can be a tension release. “That’s one of the reasons why it becomes such a difficult behavior to end,” agrees Gabrielle Carlson, MD, Director of the Division of Child and Adolescent Psychiatry at Stony Brook University Hospital. “It’s such a relief to feel better.”

How you can help

Understanding why someone hurts herself and can’t just stop doing it may be difficult for you, too. Be prepared to deal with feelings of disgust and fear. I is important for you to comment on the behavior and convey concern, without criticizing. “(Healthy) relationships are the antidote,” Levander says. “Self-injury happens in the absence of relationships.”

People can’t be coerced into stopping the behavior. They have to be willing to try to change their behavior. Here is how you can help:

  • Determine whether the injuries require medical care. Always take care of a medical emergency first.
  • Read about self-injury. It is important to not try to be a mental health professional. It will likely overwhelm you and might harm the individual.
  • Make it clear that your loved one can talk to you about the behavior, and that you aren’t repulsed. It is alright to say that you are overwhelmed by the injuries and the pain they must be causing.
  • Encourage your loved one to seek care and support. Work with a health care professional to help the person. “There are better ways of dealing with tension than what they’re doing,” Carlson emphasizes.
  • Help your loved one get help to explore the reasons behind her behavior. 
  • Place the responsibility for the behavior on your loved one. If she tells you about an episode of self-injury, ask, “How would you like me to respond to that?”
  • Be supportive without reinforcing the behavior. Project confidence, optimism, and empathy. Say, for example, “You’ve been so brave to deal with this issue.”
  • Set reasonable limits to help keep the relationship intact. You might say, “I can’t talk to you while you’re actually cutting yourself because it hurts too much to watch.”
  • Provide distractions if necessary.
  • Be patient. It can take a long time for a person to give up self-injury.

What not to do

People who self-injure may expect to receive angry, rejecting responses. Break that pattern.

  • Don’t give ultimatums. They won’t work.
  • Don’t expect the person to be able to “snap out of it.” Saying, “There, now it’s over,” is not helpful. Instead, say, “Let me help make it better.”
  • Don’t ask, “Is there anything I can do?” Find ways you can help and ask, “Can I?”
  • Don’t give pat responses. The emotions surrounding the problem are complicated. For example, if your loved one tells you she feels repulsive, don’t simply say, “You’re not repulsive.” Ask why, and explore those factors.
  • Set limits for yourself. The person’s needs may overwhelm you. Refer him to professional care, when appropriate.

You also have to care for yourself. You may feel frustrated and stressed. Make sure you set limits—as much as you care for your loved one, you might have to take a break. Seek out support for yourself.

Resources

The Healing House
www.healing-house.org
 
Helping Teens Who Cut: Understanding and Ending Self-Injury by Michael Hollander. The Guilford Press, 2008.

Stopping the Pain: A Workbook for Teens Who Cut and Self-Injure by Lawrence Shapiro. Instant Help, 2008.

By Kristen Knight
Source: Gabrielle Carlson, MD; Andrew Levander, MA, MAC; American Self-Harm Information Clearinghouse; BBC News; CNN.com; Discovery Health Channel; Focus Adolescent Services GuardianUnlimited; The Healing House; Vista Del Mar Child and Family Services; A Bright Red Scream: Self-mutilation and the Language of Pain by Marilee Strong; Bodily Harm: The Breakthrough Healing Program for Self-Injurers by Karen Conterio and Wendy Lader, PhD; Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron; Women and Self-Harm: Understanding, Coping, and Healing from Self-Mutilation by Gerrilyn Smith, Dee Cox and Jacqui Saradjian.

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